Laserfiche WebLink
SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />Changes to EnvisionConnect by CERS Integration Wizard <br />Date run: 9/14/2015 <br />Submitted on: 9/8/2015 9:56:56AM CERS ID: 10642324 <br />Submitted by: Jill Carlson Email: jcarlson429@gmail.com Facility ID in CERS: incorrect <br />Information after CIW processing <br />(current submittal) <br />Maddox Resources Inc. <br />jcarlson429@gmail.com <br />Oakdale, CA 95361 <br />2098471025 <br />CERS <br />field <br />111 <br />113 <br />114, 115, 116 <br />112 <br />Facility ID <br />Information prior to CIW processing <br />OWNER INFORMATION <br />(current EC database) <br />Owner ID <br />OW0000533 <br />Owner name <br />MADDOX RESOURCES INC <br />Mailing address <br />161 N SECOND AVE <br />1255 Lillian Ave <br />OAKDALE, CA 95361 <br />Work phone <br />209-847-1046 <br />FACILITY FILE INFORMATION <br />Information after CIW processing <br />(current submittal) <br />Maddox Resources Inc. <br />jcarlson429@gmail.com <br />Oakdale, CA 95361 <br />2098471025 <br />CERS <br />field <br />111 <br />113 <br />114, 115, 116 <br />112 <br />Facility ID <br />FA0018622 <br />Facility name <br />MOUNTAIN MIKE'S PIZZA <br />Mountain Mikes Pizza <br />3 <br />Site address <br />1255 LILLIAN AVE STE C <br />1255 Lillian Ave <br />103 <br />City <br />ESCALON <br />Escalon <br />104 <br />ZIP code <br />95320 <br />95320 <br />105 <br />Facility phone <br />209-838-8200 <br />209-838-8200 <br />102 <br />Facility mailing address <br />161 N SECOND AVE <br />161 North Second Ave <br />108a <br />OAKDALE, CA 95361 <br />Oakdale, CA 95361 <br />108b, 10ac, 10sd <br />BILLING INFORMATION <br />Contact name MOUNTAIN MIKE'S PIZZA Maddox Resources 140 <br />Address 161 N SECOND AVE 161 North Second Ave 143 <br />OAKDALE, CA 95361 Oakdale, CA 95361 144, 145, 146 <br />Contact phone Not Specified 2098471025 141 <br />Contact email jcarlson429@gmail.com 142 <br />Mail invoices to Fac ity � <br />Program record [ ] HMBP [ ] SQG HW [ ] LQG HW [ ] RCRA HW New PR#: <br />created [ ] Tiered permit [ ] APSA [ ] CalARP [ ] UST New PE: <br />Assigned to: <br />Please bill: [ ] full calendar year [ ] prorate `�Ithis,calendar year [ ] next calendar year [ ] exempt from billing <br />Processed through CERS Integration Wizard by: V� " Date: � , I y � I <br />-------------------------------------------------- <br />Accounting: Reviewed by: tJ Date: q114115 -Clerical: [ ] File [ ] Relabel file [ ] Create new file <br />TcT Vi FeT [ ] Surcharge verified By: Date: <br />--------------------------------------------------- <br />ACTIVE PROGRAM RECORDS PRIOR TO PROCESSING THROUGH CIW <br />Program Element and Description Record ID Employee name Status Reactivated Inactivated <br />1625 - RESTAURANT/BAR 51-100 SEATS PR0527490 KADEANNE LINHARES Active [ ] [ ] <br />1921 - HMBP-Regular-Primary Location PRO540403 NICHOLAS LOEHRER Active [ ] [ ] <br />